cosmetic dentistry_ beauty & science

case report _ red-white aesthetic I 22 and 23. In addition, she was unhappy about the grey colour of her maxillary gingiva and enquired whether it could be addressed. Teeth 13–23 had been restored with PFM single crowns 15 years before (Figs. 1–3). After a detailed discussion of the state of the art in anterior aesthetics, we decided to renew all six PFM crowns and replace them with IPS e.max crowns (Ivoclar Vivadent). For all ante- rior cases, IPS e.max is our first choice of mate- rial. Not even all ceramic is all ceramic. Zirconium has nearly the same light transmission as PFM— almost nothing. Of course development goes on, and the first translucent zirconia products have beenmadeavailable.Itisfirstnecessaryto understand what causes a grey-coloured ridge in patients provided with PFM crowns. There are two principal reasons. The first is the umbrella effect.1 This appears only with PFM and sometimes with zirconium crowns.Theopaquecopingsblockthelight(Figs.4a & b) so the root is not able to transmit the light and brighten up the papilla from the inside. Lithium disilicate glass-ceramic (except for the MO and HOingots)isabletomimicthenaturaltooth.Owing to the mineral (crystalline) structure of the tooth substance and the natural light transmission of the IPS e.max restoration, the light is scattered in all the mandibular anterior teeth for the ceramic build-up. Figs. 17–19_IPS e.max crowns in situ at the try-in. Fig. 20_Controlling the shade, including the lips. Figs. 21–24_Controlling the approximal areas. I 15cosmeticdentistry 2_2013 Fig. 15 Fig. 22 Fig. 23 Fig. 24 Fig. 12 Fig. 16 Fig. 9 Fig. 10 Fig. 11 Fig. 19 Fig. 20 Fig. 21 Fig. 17 Fig. 18 Fig. 13 Fig. 14